For North Shore LIJ, which already has 15 hospitals and 5,000 beds, affiliation with Lenox Hill represents an opportunity to expand beyond Queens, Long Island, and Staten Island across the bridge into Manhattan for the first time.

"We're broadening our footprint," while benefitting from even greater economies of scale, says NS LIJ President and CEO Michael Dowling. He added that it was a natural affiliation, because Lenox Hill already draws patients from Queens.

For Lenox Hill, a 153-year-old stand-alone facility situated two blocks east of Central Park, Dowling says, the benefits are obvious. It has been financially disadvantaged in New York's extremely competitive healthcare market because it is a single facility not affiliated with any other healthcare system, as many hospitals now are.

Also, with changes coming to improve quality throughout the healthcare industry as well as those mandated by health reform legislation, Dowling says, hospitals like Lenox Hill need the strength to compete with larger organizational structures' bargaining clout.

"We're going to have to be more accountable for our outcomes. We're going to have to take care of patients throughout the continuum of illness, and manage populations of people rather than individuals," Dowling says.

"And you can't do any of this today unless you're part of a large system."

No layoffs are planned; however, Dowling says some staff will be lost through attrition over the next two years. One way the amalgamated system will save money is by extending North Shore LIJ's electronic medical record system to Lenox Hill, which has not yet made the investment, Dowling says.

Also important is the consolidation of basic back office functions throughout the 16-hospital system. "We don't have individual back office functions, like HR, finance, procurement, facilities construction, legal, planning and analysis," and many other departments, all of which will be run centrally throughout the system.

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